Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.03.009
Brazilian Journal of Anesthesiology
Case Report

Awake craniotomy for eloquent pial arteriovenous fistula - Anesthetic and surgical consideration of a rare case

Márcio Cardoso Krambek, João Luiz Vitorino-Araujo, Renan Maximilian Lovato, José Carlos Esteves Veiga

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Abstract

Intracranial pial Arteriovenous Fistulas (AVFs) are rare cerebral vascular lesions composed of one or more arterial connections to a single venous channel. We report a 50-year-old patient with a ruptured pial AVF located in an eloquent area. Microsurgery for pial AVF occlusion was proposed with awake craniotomy for motor function and neurological evaluation. Awake craniotomy is a technique that is especially useful for cerebral vascular lesions in eloquent areas, where an occlusion often compromises or suppresses the blood supply, culminating in ischemia with consequent transient or definitive deficits in neurological function.

Keywords

Arteriovenous fistula,  Awake craniotomy,  Anesthesiology,  Vascular disorders

References

1 P.J. Madsen, S.S. Lang, J.M. Pisapia, et al. An institutional series and literature review of pial arteriovenous fistulas in the pediatric population: clinical article J Neurosurg Pediatr., 12 (2013), pp. 344-350

2 S.I. Abdulrauf Awake craniotomies for aneurysms, arteriovenous malformations, skull base tumors, high flow bypass, and brain stem lesions J Craniovertebr Junction Spine., 6 (2015), pp. 8-9

3 H. Hedayat, D.R. Felbaum, J.E. Reynolds, et al. Awake craniotomy for the treatment of a cortical pseudoaneurysm in a pregnant patient Cureus., 9 (2017), Article e1921

4 R.M. Lovato, J.L. Vitorino Araujo, J.C. Esteves Veiga Low-cost device for fluorescein-guided surgery in malignant brain tumor World Neurosurg., 104 (2017), pp. 61-67

5 H. Duffau Is non-awake surgery for supratentorial adult low-grade glioma treatment still feasible? Neurosurg Rev., 41 (2018), pp. 133-139
 

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